Medical Mission in Chitokoloki

by Julie-Rachel Elwood

While growing up, I wanted a profession that I could use to serve the Lord wherever He would call me. He led me into nursing. I love the work, the opportunities to draw close to people and the doors that such relationships open. Nursing allows access to hearts and lives in a way that is not possible in some other professions.

I first came to Chitokoloki Mission Hospital in Zambia in 2002. The greatness of the need gripped me. Even as a shy student, not yet qualified, the Lord pressed upon me how much I could do for Him in this place. Few people could read and I felt particularly inspired when I went to visit villages with Sandy, the nursing sister here at the time. Without knowing the language, I wouldn’t be able to tell people the gospel but I could certainly read the Bible to them.

In those early days, medical work was more basic and Dr McAdam was working to develop and improve standards of care. Personally, I have learnt so much in the years here. Even at the beginning, with my inexperience, I found there were plenty of jobs for willing hands. I learnt that change takes time, constant encouragement and reinforcement, but it does occur. A lot has changed in those 16 years and much is just the same. Our world is changing and so too, mission must be dynamic and adapt to the needs of today.

In Zambia, the average life expectancy is 60 years; in 2002 it was only in the forties. Healthcare, education and living standards are improving. It used to be rare to see a vehicle in Chitokoloki; now, there are usually three or four parked outside the hospital, traffic passes by frequently and travel is increasing. Many people have a mobile phone. Yet, it is still a relatively poor area, dependent on subsistence farming. Those with paid employment are wealthier, but the poverty gap is widening with many people struggling from day to day. There is little in the way of official help for orphans or those with disabilities. The mission provides somewhere for these suffering people to receive help. ‘For you have the poor with you always, and whenever you wish you may do them good…’ (Mk 14:7).


There are many challenges and where there is a work for the Lord, the devil is also busy causing problems and strife. Witchcraft and belief in traditional medicine are still as strong as ever. It is hard to see people attending hospital with diseases that would likely have been curable at the time they first went to the witch doctor. After many months of the problem worsening, as a last resort they attend the hospital – by which stage, there is little we can do. This affirms the belief implanted by the traditional healers, that you will die if you go to the hospital. It is a frustrating situation.

So too are the injustices of society, where crimes such as rape are considered acceptable in the community and go unreported. If a woman leaves her husband the children will stay with him, so she continues to accept daily abuse and violence rather than leave her family behind. Sexual immorality is actively encouraged and teen pregnancy celebrated as proof of fertility. Such attitudes are not going to change in a single generation. However, little by little things can change. It is encouraging to see that female literacy has dramatically improved. When I first arrived, few women could even write their name. This is now rare.

Lack of blood for transfusions is a constant challenge. It is difficult to see people dying here for lack of simple treatments. Instead, we have to continually focus our minds on the many who are helped and actively advocate for our patients to ensure future individuals have better options. As a medical mission worker, it is an emotional rollercoaster – life and death are ever present. We are involved in CPR one minute and then delivering a baby the next. And yet, the awareness of life and death acts as a constant reminder that life is short and people must hear the gospel before it is too late.

The mission provides somewhere for these suffering people to receive help.

A Changing Workforce

We are seeing a shift in our hospital workforce. Chitokoloki used to be staffed by individuals who were trained locally by mission workers. These people were members of the community, who spoke the local languages and were mostly Christians recognised for their potential. Today, as local staff reach retirement age their replacement by locally trained staff is discouraged and increasing numbers of university trained staff are posted to Chitokoloki by the government. As a result, most of our current staff are not believers. They do not speak local languages or have the same focus of spiritual care as our local Christian staff. It is more crucial than ever before that mission workers learn local languages well. In fact, our Zambian colleagues often look to us for help with communication to our Lunda- and Luvale-speaking patients.

A constant turnover of new people means that staff retention is difficult. In general, staff are from urban areas. They are often shocked and disappointed to be posted to a bush area, far from their families without the attractions that city life offers. Wives and husbands who are separated from their families jump at the chance to return to their loved ones as soon as an opportunity for a transfer arises. A number of our local Christian young people have attended nursing college, but we find it difficult to get them posted back to Chitokoloki. Therefore, it is hard to find senior staff or encourage a Zambian management team. This changing workforce has brought us a number of challenges, but also new gospel opportunities.


There is an important role for mentorship, not just in terms of the medical work itself, but also to draw alongside colleagues who are lonely and far from home. The gospel is preached daily throughout the hospital in various ways. Although individuals may only stay a short time at Chitokoloki, they will hear the message of salvation. We hope and pray that they will come to know the Lord during their time here.

Changing Times

The medical work itself is changing at a rapid pace and the use of technology is increasingly common. We have better access to power, with a large solar-powered system allowing us to utilise electrical equipment and offer more treatment options. We continually work to improve the quality of care we provide, such as laparoscopic surgery and general anaesthesia that were not available ten years ago.

With the increased accessibility of technology and media, a whole world of ideologies has opened up. People are confused, and there is a need for teaching and direction on how to deal with this information overload. In particular, guidance on discerning the truth is needed. Good solid Bible teachers are required to help Christians understand and grasp the core principles of their faith. Cultural beliefs and fear of witchcraft hold strong, even among Christians. A number of visitors come to give special sessions of Bible teaching, which have been beneficial.

Chitokoloki has an excellent reputation within Zambia and neighbouring countries. People come from all over for care. We are regularly full to capacity with multiple floor beds. Surgery and medical needs are constant and often overwhelming. The medical work itself can become all-consuming. There is a need for workers with a focus on preaching and teaching.

People are confused, and there is a need for teaching and direction on how to deal with this information overload

People of Every Kind

Time is a great adversary. As Zambia continues to develop, the requirements for things such as statistics and paperwork increase. It is frustrating to have to spend time on administrative tasks when souls need Christ. There is a need for people who are willing to help meet the demands of running such an institution. ‘But now God has set the members, each one of them, in the body just as He pleased. And if they were all one member, where would the body be?’ (1 Cor. 12:18-19).

I have learnt that what is needed on the mission field is a mix of roles, covering both medical and spiritual needs. A person wishing to serve the Lord should not think that they need to be a teacher or a nurse to be useful on the mission eld. The Lord has need for people of every kind and He will equip each one for the specific work He has for them to do.

Opportunities to Witness

Opportunities for the spread of the gospel are great. Patients are regularly admitted for weeks and months at a time, giving ample opportunity to build relationships, and witness to them and their families. We build close, lasting bonds. There is a thirst for literature and reading material, especially in local languages.

Those involved in translation, printing and publishing provide a much-needed service. Many bed-bound patients are otherwise well and appreciate messages, books and visitation to stem boredom. The hospital is an ideal place to provide patients with literature to read. When I give a patient a Bible or a gospel tract, others ask for one too. It is a joy to see rows of individuals reading material as they wait in the various clinic lines. The hospital walls are adorned with verses and gospel messages are preached daily throughout the wards.

One man, who returned for cataract surgery on his second eye, told us he had wanted to kill himself when he went blind. During his time at Chitokoloki, he had the cataract removed from one of his eyes, which restored his vision, and he was saved during his time in hospital. Both physical and spiritual vision received; how we rejoice at such testimonies!

Chitokoloki Mission Matters

As I serve the Lord in medical mission work here at Chitokoloki, I am reminded that there are still people without Christ and Christians needing encouragement. We are a new generation serving a new generation. However, as the generations before us, we continue to shine as lights in this dark world. ‘…O God, do not forsake me, until I declare Your strength to this generation, Your power to everyone who is to come’ (Ps 71:18).

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